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Speech Disorders GRAD > Final > Flashcards

Final Flashcards

1
Q

Most popular artic test

A
  • Goldman Fristoe
  • Kahn Lewis phonological complementary test
  • DEAP
  • PAT
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2
Q

Artic tests designed to

A
  • elicit spontaneous naming based on presentation of pics
  • similar to expressive vocab test
  • listening for a target phoneme in a specific position
  • blends in beg. Of words
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3
Q

4 Problems with artic tests

A
  • only examines sounds/phonemes in selected words. 1 shot deal binary scoring +/-
  • doesn’t give enough info about phonological system of child
  • don’t test all sounds in all contexts in general American English
  • look at limited aspect of c’s total ability. Only small portion of their articulatory behavior
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4
Q

Factors to consider when selecting an artic test (4)

A
  • tests appropriateness for age/developmental level of client
  • can the test supply a standardized score
  • does test analyze the sound errors
  • does it include an adequate sample of the sounds
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5
Q

Supplemental info of artic tests (4)

A
  • try best to record your assessment esp. for speech/lang sample
  • easier to analyze in naturalistic setting
  • transcribe entire word
  • determine stimulability for error sound production
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6
Q

Scoring artic tests (2 ways)

A
  • binary: +/- right or wrong
  • 5 way: gives opp. To analyze error productions, document event
  • SODA
  • correct
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7
Q

SODA

A
  • Substitution
  • Omission
  • Distortion
  • Addition
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8
Q

Phonetic Transcription

A
  • documents speech event it does not judge.
  • more precise than writing own symbols
  • universal way to document comm.
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9
Q

Narrow Markers

A

-further delineates the characteristics of the error

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10
Q

Stimulability Testing

A
  • for correct target production
  • can client able to produce /ch/ phoneme can stop /t/ or deaffricate /sh/–closer in production
  • can client correctly produce target sound
  • start w. sound in isolation, cv syllable (open), CVC syllable (closed)
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11
Q

Spontaneous Language Sample

A
  • minimum of 3-5 minutes
  • make sure you have planned so you know what your client likes, know your audience
  • plan for some diversity not all toys, use a storybook, magic bag of toys w. something broken
  • audio/video record in right environment
  • transcribe as much as you can on the spot
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12
Q

Oral Motor Exam aka oro-motor

A
  • eval of speech mech.
  • necessary to evaluate both STRUCTURE and FUNCTION of speech mech.
  • 5 steps
  • also diadochokinesis
  • assess lingual function and structure, protrude, elevate, lateralize, rotate clockwise, depression, rotate counterclockwise
  • look at respiration basic at rest 1:1 resiprosity inhalation/exhalation
  • open mouth breather and cavicular breathing
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13
Q

1st step of oral motor exam

A
  • head and face
  • symmetry
  • proportion eyes same size spaced equally
  • overall appearance, drooping, lack of muscle tone–distinctive features
  • note birth marks casually
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14
Q

2nd step of oral motor exam

A
  • dentition (teeth)
  • normal class 1 occlusion
  • class 2 malocclusion (overbite)
  • class 3 underbite
  • turning/rotating of teeth in or out
  • missing teeth
  • discoloration, bottle rot
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15
Q

3rd step of oral motor exam

A

-tongue: normal size, color, and texture

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16
Q

4th step of oral motor exam

A
  • hard and soft palate, need pen light
  • smooth transition from hard palate to soft
  • ruggae (bumpies)
  • make sure no cleft
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17
Q

5th step of oral motor exam

A
  • tonsils and uvula
  • normal size, shape, color
  • should look like tear drop
  • biped uvula has slit
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18
Q

diadochokinesis

A

-ease of movement: able to produce individ phonemes of /p^t^k^/ w ease and accuracy

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19
Q

other assessment measures

A
  • approx. 80-85% of clinical pop w delayed speech &/or disordered speech will have associated lang. problems therefore lang. testing is recc. for every c who has phonetic or phonemic disorder
  • rarely are artics just artic problems. affects academically syntax, pragmatics, semantics, morph.
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20
Q

Hearing Screenings

A
  • in school by nurse.
  • identification audiometry
  • need history-call parent, ear infection, myringotomy placement-tubes in ears for chronic infections
  • visual inspection
  • acoustic immittance measures tympanogram
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21
Q

Cognitive Appraisal

A
  • not qualified for IQ testing
  • test speech, lang, fluency..
  • c will have lower iq scores if lang/speech problems
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22
Q

IQ

A
  • verbal, predetermined ability

- performance skills acquired during formal educational training

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23
Q

Special Considerations

A
  • emerging phonology-pd. where conventional words begin to appear as a means of comm
  • ch w developmental delays/disorders emerging
  • phon. phase is different much smaller expressive vocabs their wods more likely unintell
  • reduced repertoire of consonants as normal developing peers
  • negatively impact semantics and morphosyntactic development
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24
Q

Independent Analysis

A
  • analyzing clients productions
  • not compared to adult model of norm need 3 types of data
  • inventory of speech sounds: all vowels & cons. productions of c
  • syllable shapes c uses: using single sound prod. for everything? limiting to k, g, s….
  • constraints on sound sequence of c: sound combos not producing? so substituting use same sequence of sounds & overuse them
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25
Q

Dialects

A
  • lang variation/difference, not a disorder
  • spoken by members of a partic. region, cultural or social community
  • difference in pronunciation based on geographical or cultural background
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26
Q

Regional Dialects

A

-represent a set of ling. features where pronunciation is predominant words pronounced a very specific way

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27
Q

Cultural Dialects

A
  • rule governed
  • most prevalent dialect is African Am. English
  • no pluralization, certain rules w.in cultural dialect
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28
Q

ESL

A
  • speakers of engl. as 2nd lang.
  • LOTE
  • languages other than english
  • ELL-english lang. learners
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29
Q

Unintelligible Child

A
  • so disordered that their message really can’t be understood even in a shared context dinos, thomas, farm should be able to understand pig from horse from him
  • not limited to any specific age group bc many are transients
  • best way to go is choose topic you know they like and attempt to structure convo high amnts. of structure
  • use routine & scripted events
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30
Q

Routine

A
  • c knows and understands progression of sequence

- brushing teeth, make pbj, make bed, trick or treating

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31
Q

scripted activities

A
  • activities they have performed before
  • what they are learning in class
  • please excuse my..
  • they are familiar w the vocab
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32
Q

Phonological Process Analysis

A
  • try to id what subs are begin made but looking at patterns of phonological processes
  • constantly fronting, backing, stopping
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33
Q

severity

A
  • more objective
  • attempt to quantify degree of involvement
  • mild, moderate, severe, profound
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34
Q

intelligibility

A
  • judgement very subjective made by clinician based on how much of utterance can be understood
  • perception regarding client’s intell is influenced by many factors
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35
Q

factors intelligibility are influenced by

A
  • volume
  • acoustics
  • visuals of speaker
  • prior knowledge
  • experience
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36
Q

prognosis

A

-expected or anticipated progress over an extended pd of time

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37
Q

Phonetic Approach

A
  • traditional or motor approach

- each sound is treated individually one after other

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38
Q

phonetic errors

A
  • motor production problems
  • client is directed where to position their artics
  • use a mirror, visuals
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39
Q

multiple sounds approach

A
  • teach multiple sounds at a time
  • can be very confusing
  • use if sounds are very different
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40
Q

Therapy Sequence

A
  • 80-85% accuracy over 3 or more consecutive sessions is considered mastery
  • certain stages are needed for some, others not
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41
Q

Dismissal Criteria

A
  • a lower level of accuracy is acceptable in spont. speech contexts
  • 50% accuracy over 3 sessions in spontaneous speech
  • assume client will generalize skill
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42
Q

Ear Training/ Auditory Discrim

A
  • client develops ability to discrim btwn target sound & irregular sound production they are making
  • client asked to listen & discrim clinician’s speech (interpersonal discrim)
  • id old way vs. new way
  • want them to id called isolation phase
  • stimulation phase-provide auditory bombardment “L” in story, stimulate them
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43
Q

Metalinguistic Skills

A

-requires to think about lang

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44
Q

discrimination

A

-putting sound in diff positions

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45
Q

Sound Modification Method

A

-modifying sound by finding phonetically similar sound that client can already accurately produce /s/ can produce and /f/ cant produce are continuiants..show similarities and work w what they have

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46
Q

several factors that affect articulatory complexity of words

A
  • length of word
  • position of sound w in a word
  • syllable structure
  • syllable stress-easier to produce in stressed part of word
  • client’s familiarity w word
  • coarticulation factors- vowels or cons. that either precede or post-cede are going to influence target production
47
Q

structured contexts (carrier phrase)

A
  • I see the… structured sentence, repetitive
  • there is the
  • where is the
  • here is the
48
Q

True Sentence Phase

A
  • it was a sunny day at the beach.

- take target word and have client put it in a sentence

49
Q

conversational level of speech

A
  • hardest bc least structured everything else is controlled
  • convo is a continuous flow
  • don’t speak and pause one sentence at a time
  • continuous awareness aka generalization
50
Q

-Dismissal and Re-evaluation Criteria

A
  • 50% over 3 sessions

- assume competency will increase over 3 sessions

51
Q

Most Common Misarticulated

A

-s& z, l, r, th voiced and vl, k & g, sh, 3

52
Q

misarticulated /s/

A
  • th for s tongue thrust (interdental lisp)
  • lateral lisp (slushy) bc tongue flattens out & air escapes
  • palatal s sounds snooty more sh
  • strident s- whistling
  • stopping of s= t/d
  • if teaching /s/ initial pair w. front vowel front anterior, and high= sl, st, sp, *sn, sm, *sw
53
Q

3 basic principles to most therapeutic approaches

A
  1. naturalistic communicative context should be emphasized
  2. all approaches work off of phonological contrasts
  3. group sounds w similar error patterns
    - most approaches will use minimal pairs
    - cycles training-drill and kill
54
Q

Minimal Opposition Therapy

A
  • meeting w least resistance
  • work on 2 sounds that are phonemically similar & use them together
  • works well for c who is stimulable for both sounds & able to produce both
55
Q

Maximal Opposition Therapy

A
  • looking for 2 target sounds that are as different as can possibly be & try to introduce them into c’s repertoire
  • p & 3 for moderate to severely phonologically impaired kids it works
56
Q

which sounds to start w? 6 considerations

A
  1. phonemic subs. actually form basis for target selection look at sounds mispronouncing & should already be saying
  2. place, manner, voicing features need to be analyzed & considered
  3. sounds that (-)ly impact c’s intelligibility most have priority
  4. age & developmental level need to be taken into consideration
  5. stimulable sounds
  6. sound subs should have the least # of differences
57
Q

Childhood Apraxia of Speech

A
  • children who lack evidence of motor control of oral mech. for speech production purposes
  • can’t be attributed to any muscular control
  • lack of coordination
  • approx. 1-2 children/ 1000 live births
58
Q

Characteristics of Childhood Apraxia of Speech

A
  • sequencing errors: disruption in producing sounds in correct order
  • groping behaviors: artics try to get to correct position but can’t quite get there. cant get to right destination
  • silent posturing: artics ready to be in position but not producing any sound
59
Q

Comprehensive Eval for Childhood Apraxia of Speech includes:

A
  • background info
  • oral motor exam
  • hearing screening
  • articulation assessment
  • language testing
  • language sampling
60
Q

Therapeutic Strategies for Childhood Apraxia of Speech (8)

A
  • high amnt of intensive individ. therapy
    1. drill and kill, repetition to train muscles to get used to a correct pattern
    2. start easy and increase task demand
    3. carefully increase sequential movements to help improve muscle memory. basketball, play basketball, i like to play basketball
    4. multi modalities should be employed when possible. tactile, auditory, visual bc everyone learns different
    5. age approp. self monitoring needs to be taught use mirror, apps
    6. intensive work on prosidy to reduce monotone
    7. additional compensatory strategies
    8. provide experiences that all them to have success
61
Q

CP

A
  • motor disorder
  • caused by damage to developing brain of fetus
  • could be during prenatal (crack), perinatal (antibiotic), or postnatal (anoxia at birth)
  • end result will be dysarthria of speech
62
Q

CP will effect:

A
  • respiration
  • resonation
  • phonation
  • articulation
  • prosidic features
  • VPI
63
Q

3 types of Involvement in CP

A
  1. Spasdic
  2. Ataxic
  3. Dyskinetic
64
Q

Spasdic

A
  • spacticity

- weakness, limited range of motion, slowness

65
Q

Ataxic

A
  • ataxia

- slow, hypotonia, poor prosidy

66
Q

Dyskinetic

A
  • dyskinesia
  • involuntary mouth and tongue movements or diminished capacity.
  • doesn’t have the strength
  • hypo and hyperkinetic
67
Q

Assessment of CP

A

-language competence, feeding, swallowing, hearing

68
Q

4 Pre-speech requisites must be met for Therapy CP

A
  1. head control strengthen muscles
  2. coordinate respiration with articulation
  3. chewing reflexes need to be worked on to eliminate extraneous oral motor movements
  4. increase speed, range, and accuracy of artics
69
Q

Therapy CP

A
  • treat groups of sounds/clusters

- treat distortions first bc distortion is closer approximation of the sound

70
Q

Cleft

A
  • division of a continuous structure
  • cleavage or a split
  • result of failure of fusion of lip &/or palate
  • happens during fetal development
71
Q

Team Approaches Necessary for Cleft

A
  • SLP

- plastic surgeon- maxilofacial

72
Q

With cleft lip there will be VPI which will result in

A
  • hypernasality
  • nasal air emission (nasal snort)
  • sound substitutions
  • sound distortions
73
Q

Phonemes affected by VPI

A
  • plosives
  • fricatives
  • sibilants
74
Q

VPI

A

-lack of intraoral air pressure building up

75
Q

Evaluation of Cleft includes:

A
  • speech sample
  • stimulability- what capable of producing
  • oral motor exam
  • judgement of inteligibility
76
Q

Most children with cleft will have how many surgeries?

A

-2-3 surgeries by 18 months

77
Q

Cleft Therapy Goals

A
  1. improve velopharyngeal function to reduce hypernasality
  2. improve placement for consonant production work on more forward sounds
  3. modify artic whenever possible
78
Q

Severe Cognitive Disabilities

A

-substantial limitations significantly impacting cognitive functioning.

79
Q

Severe Cognitive Disabilities difficulty with following 10 Adaptive Skills:

A
  1. communication
  2. self-care grooming, feeding
  3. home living ADL
  4. social skills pragmatics
  5. community life post office, grocery shopping
  6. health and safety
  7. functional academics telling time, money, phone #
  8. leisure/ enjoyment
  9. work/employment
  10. self-direction knowing when have to go to bathroom
80
Q

Severe Cognitive Disabilities facts:

A
  • these disorders will manifest themselves prior to age 18 w. exception of TBI
  • approx 70% of this pop will have speech prod. difficulties
  • deletion of consonants
  • inconsistent error productions
  • immature speech pattern similar to child w. a delay
81
Q

Diagnosis of Severe Cognitive Disabilities

A
  • extensive lang. testing
  • artic testing
  • sponteous lang. sample
  • oral motor exam
  • background info
  • same as others
  • assess environment they live in linguisitc demands
82
Q

6 General Therapy Principles for Severe Cognitive Disabilities:

A
  1. repetition
  2. when possible train in their natural environment
  3. begin as early as possible w therapy
  4. follow developmental guidelines when possible
  5. enlist help of caregivers when possible
  6. activities should serve daily routine
    - activities should be short in duration, repetitive, and serve a purpose.
    - focus on global inteligibility
83
Q

Hearing Loss/ Impairments

A
  • any diminished ability in normal sound reception

- described by TYPE and DEGREE of auditory dysfunction

84
Q

3 types of Hearing Loss:

A
  1. conductive
  2. sensorineural
  3. mixed
85
Q

conductive hearing loss

A
  • effects mechanical transfer of sound waves
  • treatable w meds or surgery
  • manageable w hearing aids
  • caused by chronic otitis media
  • wax build-up
  • bug in ear, toy
86
Q

sensorineural hearing loss

A
  • caused by damage to hair cells w/in cochlea or auditory nerve
  • acoustic neuroma (tumor on auditory nerve)
  • continuous prolonged noise exposure
87
Q

Hearing Level

A
  • measured in decibel
  • tells degree of loss based on threshold findings
  • start at 10 or 15 dB drop 10 up 15
88
Q

With hearing loss could be errors in:

A
  • stress, pitch, and voicing

- vowel productions tend to be neutralized

89
Q

Therapy for Hearing Loss

A
  • improve as much of residual hearing as you can through speech sound amplification, hearing aids, FM trainer, desktop amplifier
  • auditory and articulatory training
90
Q

6 General Characteristics of Childhood Apraxia of Speech:

A
  1. unsuccessful attempts at self-correction
  2. disturbances in prosidy
  3. difficulty initiating an utterance
  4. sound substitution errors
  5. errors will occur as length increases
  6. can sometimes recognize their errors
91
Q

Speech Inventory

A

-all productions client can produce both correct and incorrect

92
Q

Distribution of Speech Sounds

A

-where error occurs in the word (initial, medial, or final)

93
Q

Primary Phonetic Emphasis

A
  • diagnostic info that will help us guide where we start therapy
  • stimulability
  • inteligibility
  • contexts for correct production
  • dealing w place, manner, and voice analysis (how does it go wrong)
94
Q

Distinctive Feature Analysis

A

-patterns characterized by frequent use of 1 or more identical features when the target sound & substitution sounds are compared

95
Q

Articulation and 3 Components

A
  • used to describe a person’s speech
  • Respiration: automatic process, breath support achieved through lungs, rib cage, airways, diaphragm, and other structures
  • Resonation: involuntary, altering size and shape of vocal tract
  • Phonation: conscious process, onset and initiation of speech production sets off vfs into vibration through movement of air
96
Q

3 Categories of Phonetic Production

A
  • place
  • manner
  • voice
97
Q

Assimilation

A

-one sound becomes similar to a neighboring sound
-adaptive artic changes in which consequence of natural articulatory adjustments
-street
-bad boy bab boy
bad girl bag girl
that man thap man

98
Q

Coarticulation

A
  • pobody’s nerfect
  • result of constant positioning and repositioning of artics as they move over a stretch of speech
  • production of a sound is inflfulenced by other sounds around it due to its phonetic contact
  • jon bovi
  • peanut belly
  • snow flowers
  • framily
99
Q

Cluster Reduction

A

-blends. frog says fog
-take a cluster of 2 and reduce to 1
street=seat
-bl cr tr sm sn

100
Q

weak syllable deletion

A
  • banana= nana

- telephone= tephone

101
Q

final consonant deletion

A
  • delete final consonant

- do= dog

102
Q

reduplication

A

wawa

brabra

103
Q

fronting

A

kiss= tiss, miss, biss

104
Q

backing

A

no= go or koe

105
Q

labilaization

A

bof, valentime

106
Q

stopping

A

-fricatives/affricates replaced by stops
-sun/ tun
peach/ peat
that/ dat

107
Q

deaffrication

A

affricates replaced by fricatives
chop/ sop
chip/ ship
page/ paze

108
Q

affrication

A

fricatives replaced by affricates
saw/ chaw
shoe/ chew
sun/ chun

109
Q

denasalization

A

nasals replaced by stops
moon/ bood
nice/ dice
man/ ban

110
Q

gliding

A

liquids replaced by stops
run/ wun
yellow/ yewow
leaf/ wif

111
Q

epenthesis

A

addition of a phoneme, usually schwa

noah, bulack, galue

112
Q

metathesis

A

transposing and shifting neighboring sounds

aminal hopsital

113
Q

diminuitization

A

baby talk “ie”

doggie, bookie, wipipe

Speech Disorders GRAD (2 decks)

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